What is levsin drops




















Nursing mothers. Antacids may inhibit absorption. Additive anticholinergic effects with other anticholinergics, amantadine, type I antiarrhythmics, antihistamines, phenothiazines, tricyclics, MAOIs. Irritable bowel syndrome. Infant colic. Children Dosage: 3. Hyoscyamine Sulfate Drops Contraindications: Glaucoma. Hyoscyamine Sulfate Drops Classification: Anticholinergic.

Hyoscyamine Sulfate Drops Interactions: Antacids may inhibit absorption. Feeling confused. Mood changes. Change in how you act. Severe diarrhea. Hallucinations seeing or hearing things that are not there. Memory problems or loss. Trouble sleeping. Change in speech. Change in balance. Change in eyesight, eye pain, or very bad eye irritation.

Trouble passing urine. Not sweating during activities or in warm temperatures. Fast or abnormal heartbeat. If your child is or may be sexually active: Not able to get or keep an erection.

What are some other side effects of this drug? Blurred eyesight. Dry eyes. Upset stomach or throwing up. Stomach pain. Change in taste. Feeling nervous and excitable. Dry mouth. Feeling full. You may report side effects to your national health agency.

How is this drug best given? All oral products: Give 30 to 60 minutes before meals. Do not give antacids at the same time as this drug. Ask the doctor if you have a question about how to give antacids with this drug. All liquid products: Measure liquid doses carefully. Use the measuring device that comes with this drug.

If there is none, ask the pharmacist for a device to measure this drug. Extended-release tablets: Have your child swallow whole. Do not let your child chew, break, or crush.

Oral-disintegrating tablet: Place on the tongue and let dissolve. Maximum dosage is 7. Hyoscyamine is generally no longer used for aspiration prophylaxis prior to anesthesia. Additional 1 mg doses may be administered IM or IV every 3—10 minutes until muscarinic signs and symptoms subside; repeat dose if signs and symptoms reappear. Up to 25 mg may be required during the first 24 hours of therapy. Subsequently, 0. A cholinesterase reactivator e. Weighing approximately 3.

Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed. Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed. Immediate-release dosage forms: Administer 30 to 60 minutes before meals. Orally disintegrating tablets: Place on the tongue and allow the tablet to rapidly disintegrate and be swallowed.

May be taken with or without water. Sublingual tablets: The tablets may be taken sublingually, orally or chewed. If used sublingually, place under the tongue and allow to dissolve. Extended or Sustained-release tablets: Selected products may be broken to titrate dosage; check manufacturer specific allowances.

Do not crush or chew. Sustained-release capsules: Product should be swallowed whole; do not cut, crush or chew. Biphasic tablets e. Oral solution drops: Administer only using the calibrated dropper provided with the product.

Oral elixir or solution: Administer using a calibrated measuring device. Hyoscyamine sulfate may be administered intramuscularly, intravenously, or subcutaneously without dilution. Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit. Inject into a large muscle. Aspirate prior to injection to avoid injection into a blood vessel. The anticholinergic effects of hyoscyamine may be significant and are additive with other anticholinergic medications.

This is especially true for the older adult, but may also occur with any patient. Consider the anticholinergic burden of all applicable medication therapies and consider the potential for additive side effects. Hyoscyamine decreases bronchial secretions and should be used cautiously in patients with chronic pulmonary disease.

Inspissation and formation of bronchial plugs may occur in these patients. Hyoscyamine should be used cautiously in patients with hepatic disease, renal impairment, or renal disease.

The drug is metabolized by the liver and the resultant metabolites as well as unchanged drug are excreted in the kidneys. Further, hyoscyamine can cause urinary retention. Hyoscyamine is therefore contraindicated in patients with bladder obstruction or other urinary tract obstruction because it may aggravate urinary retention. In addition, hyoscyamine should be used with caution in patients prostatic hypertrophy.

Hyoscyamine is contraindicated for use in patients with myasthenia gravis because the anticholinergic competes with the small amount of acetylcholine that has potential to act in the body in these patients. However, hyoscyamine may be administered if it is used to reduce the adverse muscarinic effects of a cholinesterase inhibitor.

Hyoscyamine should be similarly used with extreme caution in patients with autonomic neuropathy. Hyoscyamine is contraindicated in patients with glaucoma. The mydriatic effect of hyoscyamine causes an increase in intraocular pressure thereby potentially precipitating an acute attack of glaucoma.

Psychosis has been reported in sensitive individuals given anticholinergic drugs. Central nervous system CNS signs and symptoms include confusion, disorientation, short term memory loss, hallucinations, dysarthria, ataxia, coma, euphoria, decreased anxiety, fatigue, insomnia, agitation and mannerisms, and inappropriate affect. These CNS signs and symptoms usually resolve within 12 to 48 hours after discontinuation of the drug.

Hyoscyamine causes tachycardia. Use cautiously in patients with unstable cardiac disease, especially cardiac arrhythmias, congestive heart failure, coronary artery disease, and mitral stenosis. Additionally, increases in heart rate may be undesirable in patients with hyperthyroidism or acute hemorrhage i. Like other anticholinergic agents, hyoscyamine may produce drowsiness, dizziness or blurred vision.

In this event, the patient should be warned not to engage in activities requiring mental alertness such as driving or operating machinery or performing hazardous work while taking this drug. The anticholinergic effects of hyoscyamine may make the eyes dry. This can cause an increased lens awareness, or blurred vision for wearers of contact lenses. Use of hyoscyamine may decrease sweating resulting in heat prostration or heat stroke; patients with fever or those who may be exposed to elevated environmental temperatures ambient temperature increase should use caution.

Hyoscyamine can decrease gastric motility and tone. Hyoscyamine should not be used in patients with GI obstruction including achalasia , paralytic ileus, intestinal atony, severe ulcerative colitis, or toxic megacolon. Further, hyoscyamine should be administered with extreme caution in persons with suspected or known infectious diarrhea such as dysentery, gastroenteritis, or pseudomembranous colitis.

Decreased GI motility may slow down the elimination of the bacteria or toxin from the body and thus prolong the infection. Hyoscyamine should be used cautiously in patients with gastroesophageal reflux disease GERD or hiatal hernia associated with reflux esophagitis.

Hyoscyamine decreases gastric motility and relaxes the lower esophageal sphincter. These effects promote gastric retention and aggravate reflux in these patients. Geriatric patients have an increased susceptibility to anticholinergic effects of hyoscyamine, such as constipation, dry mouth, urinary retention, possible precipitation of glaucoma, and memory impairment.

The manufacturer recommends discontinuation of hyoscyamine if anticholinergic side effects occur and continue or are severe. The anticholinergic effects of hyoscyamine may be significant and are additive with other anticholinergic medications, particularly in the elderly.

These medications have specific and limited indications based on the cause and categorization of incontinence. Patients should be assessed periodically for medication effects on urinary incontinence, lower urinary tract symptoms, and treatment tolerability. Anticholinergic medications may cause mental status changes, constipation, drowsiness, dizziness, dryness of mucus membranes, blurred vision, urinary retention, or other adverse effects that can be problematic in the elderly.

Hyoscyamine should be used cautiously in children. Infants and young children are especially susceptible to the toxic effects of anticholinergic agents. Close supervision is recommended for infants and children with spastic paralysis or brain damage because an increased response to anticholinergics has been noted. Additionally, hyoscyamine sulfate injection contains benzyl alcohol as a preservative and should not be used in neonates and premature infants. Benzyl alcohol has been associated with gasping syndrome, which is a potentially fatal condition characterized by metabolic acidosis and CNS, respiratory, circulatory, and renal dysfunction.

Hyoscyamine is classified pregnancy category C. Hyoscyamine crosses the placenta. The safe use of hyoscyamine during pregnancy has not been established. Intravenous administration of hyoscyamine during pregnancy, especially near term, may produce tachycardia in the fetus. According to the manufacturer, hyoscyamine is distributed into breast milk. Although the extent of distribution into breast milk has not been determined, the chronic use of hyoscyamine should be avoided during breast-feeding since infants are usually very sensitive to the effects of anticholinergics.

Nevertheless, the American Academy of Pediatrics has considered the use of hyoscyamine to be usually compatible with breast-feeding due to a lack of reported adverse effects in nursing infants ; single doses may not be of concern. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition.

If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA. Acetaminophen; Caffeine; Dihydrocodeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when dihydrocodeine is used concomitantly with an anticholinergic drug. Opiates increase the tone and decrease the propulsive contractions of the smooth muscle of the gastrointestinal tract.

Prolongation of the gastrointestinal transit time may be the mechanism of the constipating effect. Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.

Clinicians should note that anticholinergic effects might be seen not only on GI smooth muscle, but also on bladder function, the eye, and temperature regulation. Additive drowsiness may also occur when antimuscarinics are combined with sedating antihistamines. Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.

Acetaminophen; Chlorpheniramine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Chlorpheniramine; Dextromethorphan: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.

Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Chlorpheniramine; Phenylephrine : Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.

Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Codeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug.

Acetaminophen; Dextromethorphan; Doxylamine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Diphenhydramine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Hydrocodone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when hydrocodone is used concomitantly with an anticholinergic drug.

Acetaminophen; Oxycodone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when oxycodone is used concomitantly with an anticholinergic drug. Acetaminophen; Pamabrom; Pyrilamine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Acetaminophen; Pentazocine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when pentazocine is used concomitantly with an anticholinergic drug.

Aclidinium: Moderate Although aclidinium is minimally absorbed into the systemic circulation after inhalation, there is the potential for aclidinium to have additive anticholinergic effects when administered with other anticholinergics or antimuscarinics.

Per the manufaturer, avoid concomitant administration of aclidinium with other anticholinergic medications, when possible. Aclidinium; Formoterol: Moderate Although aclidinium is minimally absorbed into the systemic circulation after inhalation, there is the potential for aclidinium to have additive anticholinergic effects when administered with other anticholinergics or antimuscarinics.

Acrivastine; Pseudoephedrine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Alfentanil: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when alfentanil is used concomitantly with an anticholinergic drug. Alosetron: Major Concomitant use of alosetron and anticholinergics, which can decrease GI motility, may seriously worsen constipation, leading to events such as GI obstuction, impaction, or paralytic ileus.

Although specific recommendations are not available from the manufacturer, it would be prudent to avoid anticholinergics in patients taking alosetron. Aluminum Hydroxide: Moderate Antacids may inhibit the oral absorption of anticholinergics. Simultaneous oral administration should be avoided when feasible; separate dosing by at least 2 hours to limit an interaction.

Aluminum Hydroxide; Magnesium Carbonate: Moderate Antacids may inhibit the oral absorption of anticholinergics. Aluminum Hydroxide; Magnesium Hydroxide: Moderate Antacids may inhibit the oral absorption of anticholinergics. Aluminum Hydroxide; Magnesium Hydroxide; Simethicone: Moderate Antacids may inhibit the oral absorption of anticholinergics. Aluminum Hydroxide; Magnesium Trisilicate: Moderate Antacids may inhibit the oral absorption of anticholinergics.

Amantadine: Major Additive anticholinergic effects may be seen when hyoscyamine is used concomitantly with other drugs that possess antimuscarinic effects. Ambenonium Chloride: Major The muscarinic actions of ambenonium chloride can antagonize the antimuscarinic actions of hyoscyamine. Amoxapine: Moderate Depending on the specific agent, additive anticholinergic effects may be seen when amoxapine is used concomitantly with other anticholinergic agents. Additive CNS effects are also possible when these drugs are combined with amoxapine.

Antacids: Moderate Antacids may inhibit the oral absorption of anticholinergics. Aspirin, ASA; Butalbital; Caffeine; Codeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug. Aspirin, ASA; Caffeine; Dihydrocodeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when dihydrocodeine is used concomitantly with an anticholinergic drug. Aspirin, ASA; Caffeine; Orphenadrine: Moderate Additive anticholinergic effects may be seen when hyoscyamine is used concomitantly with other drugs with moderate to significant anticholinergic effects including orphenadrine.

Aspirin, ASA; Carisoprodol; Codeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug. Aspirin, ASA; Oxycodone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when oxycodone is used concomitantly with an anticholinergic drug. Atropine; Difenoxin: Moderate Diphenoxylate is a synthetic opiate derivative that appears to exert its effect locally and centrally on the smooth mucle cells of the GI tract to inhibit GI motility and slow excess GI propulsion.

The effects can be additive to antimuscarinic agents, such as hyoscyamine. In some cases, constipation might occur, and effects on the CNS or bladder function may also be additive. Atropine; Edrophonium: Major The muscarinic actions of edrophonium chloride can antagonize the antimuscarinic actions of hyoscyamine. Belladonna; Opium: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when opium is used concomitantly with an anticholinergic drug.

Benzhydrocodone; Acetaminophen: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when benzhydrocodone is used concomitantly with an anticholinergic drug. Brompheniramine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Brompheniramine; Carbetapentane; Phenylephrine: Moderate Drowsiness has been reported during administration of carbetapentane.

An enhanced CNS depressant effect may occur when carbetapentane is combined with other CNS depressants including anticholinergics.

Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Brompheniramine; Dextromethorphan; Guaifenesin: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Brompheniramine; Dextromethorphan; Phenylephrine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.

Brompheniramine; Guaifenesin; Hydrocodone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when hydrocodone is used concomitantly with an anticholinergic drug. Brompheniramine; Hydrocodone; Pseudoephedrine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when hydrocodone is used concomitantly with an anticholinergic drug.

Brompheniramine; Phenylephrine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Brompheniramine; Pseudoephedrine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.

Brompheniramine; Pseudoephedrine; Dextromethorphan: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Buprenorphine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when buprenorphine is used concomitantly with an anticholinergic drug.

Buprenorphine; Naloxone: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when buprenorphine is used concomitantly with an anticholinergic drug.

Bupropion: Moderate Additive anticholinergic effects may be seen when hyoscyamine is used concomitantly with bupropion. Additive drowsiness may occur. Clinicians should note that antimuscarinic effects might be seen not only on GI smooth muscle, but also on bladder function, the eye, and temperature regulation.

Bupropion; Naltrexone: Moderate Additive anticholinergic effects may be seen when hyoscyamine is used concomitantly with bupropion. Butalbital; Acetaminophen; Caffeine; Codeine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with an anticholinergic drug. Butorphanol: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when butorphanol is used concomitantly with an anticholinergic drug.

Calcium Carbonate: Moderate Antacids may inhibit the oral absorption of antimuscarinics. Calcium Carbonate; Famotidine; Magnesium Hydroxide: Moderate Antacids may inhibit the oral absorption of antimuscarinics. Calcium Carbonate; Magnesium Hydroxide: Moderate Antacids may inhibit the oral absorption of antimuscarinics. Calcium Carbonate; Risedronate: Moderate Antacids may inhibit the oral absorption of antimuscarinics.

Calcium Carbonate; Simethicone: Moderate Antacids may inhibit the oral absorption of antimuscarinics. Carbetapentane; Chlorpheniramine: Moderate Drowsiness has been reported during administration of carbetapentane. Carbetapentane; Chlorpheniramine; Phenylephrine: Moderate Drowsiness has been reported during administration of carbetapentane. Carbetapentane; Diphenhydramine; Phenylephrine: Moderate Drowsiness has been reported during administration of carbetapentane.

Carbetapentane; Guaifenesin: Moderate Drowsiness has been reported during administration of carbetapentane. Carbetapentane; Guaifenesin; Phenylephrine: Moderate Drowsiness has been reported during administration of carbetapentane.

Carbetapentane; Phenylephrine: Moderate Drowsiness has been reported during administration of carbetapentane. Carbetapentane; Phenylephrine; Pyrilamine: Moderate Drowsiness has been reported during administration of carbetapentane.

Carbetapentane; Pseudoephedrine: Moderate Drowsiness has been reported during administration of carbetapentane. Carbetapentane; Pyrilamine: Moderate Drowsiness has been reported during administration of carbetapentane. Carbidopa; Levodopa: Minor Through its central antimuscarinic actions, hyoscyamine can potentiate the dopaminergic effects of levodopa.

Clinicians should be ready to decrease doses of levodopa if hyoscyamine is added. Carbidopa; Levodopa; Entacapone: Minor Through its central antimuscarinic actions, hyoscyamine can potentiate the dopaminergic effects of levodopa. Carbinoxamine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.

Carbinoxamine; Dextromethorphan; Pseudoephedrine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Carbinoxamine; Hydrocodone; Phenylephrine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when hydrocodone is used concomitantly with an anticholinergic drug. Carbinoxamine; Hydrocodone; Pseudoephedrine: Moderate Monitor patients for signs of urinary retention or reduced gastric motility when hydrocodone is used concomitantly with an anticholinergic drug.

Carbinoxamine; Phenylephrine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics. Carbinoxamine; Pseudoephedrine: Moderate The anticholinergic effects of sedating H1-blockers may be enhanced when combined with other antimuscarinics.



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